A new study published in the scientific journal The Lancet on November 13 has revealed that the total number of adults living with diabetes worldwide has surpassed 800 million, more than four times the number in 1990 when approximately 198 million adults were estimated to have the disease. The analysis, coinciding with World Diabetes Day, is the first global study of trends in diabetes rates and treatment that includes all countries.
The global diabetes prevalence rate has doubled since 1990, rising from 7% to 14%, with over 828 million adults now diagnosed with either type 1 or type 2 diabetes. Alarmingly, more than half of adults aged over 30 with diabetes are not receiving treatment, highlighting significant healthcare challenges, especially in low- and middle-income countries. Of the 828 million adults with diabetes in 2022, approximately 445 million (59%) were not receiving treatment.
India now leads the world with 212 million cases of diabetes, accounting for over a quarter of the global total. This number is more than 50% greater than the next largest, which is China with 148 million adults living with the disease. In 2022, almost one-third (133 million, 30%) of the 445 million adults aged 30 years or older with untreated diabetes lived in India, underscoring the urgent need for improved treatment accessibility in low- and middle-income regions.
Professor Majid Ezzati from Imperial College London indicated that the results demonstrate increasing global inequalities in diabetes treatment. He stated, "In low- and middle-income countries, progress in diabetes treatment has actually stalled, while the number of its carriers is rapidly growing." Ezzati emphasized that "those complications include amputation, heart disease, kidney damage or vision loss—or in some cases, premature death."
The study found that the biggest increases in diabetes prevalence have occurred in developing countries, contributing significantly to the global rise in lifestyle diseases. From 1990 to 2022, global diabetes rates doubled among men, from 6.8% to 14.3%, and among women, from 6.9% to 13.9%. The changes in diabetes rates varied drastically across different countries, with mostly low- and middle-income countries experiencing the largest increases.
For example, the diabetes rate among women in Pakistan increased from 9% in 1990 to 30.9% in 2022, the largest increase among all countries. Similarly, among women in India, the rate rose from 11.9% to 23.7%, and among men from 11.3% to 21.4% over the same period. Treatment coverage for diabetes was higher in China (45% for women and 41% for men) than in India (28% for women and 29% for men), indicating a treatment gap that needs to be addressed.
In contrast, treatment rates in higher-income countries have improved, contributing to a growing disparity in diabetes care. In countries like Belgium, the highest estimated treatment rates were observed, with 86% for women and 77% for men. Countries with the lowest diabetes rates in 2022 were in Western Europe and East Africa for both sexes, and in Japan and Canada for women. For instance, diabetes rates were as low as 3-5% for men in Denmark, France, Uganda, Kenya, Malawi, Spain, and Rwanda.
Professor Jean Claude Mbanya from the University of Yaounde 1 in Cameroon said, "Our findings suggest there is an increasing share of people with diabetes, especially with untreated diabetes, living in low- and middle-income countries." He continued, "Most people with untreated diabetes will not have received a diagnosis; therefore, increasing detection of diabetes must be an urgent priority in countries with low levels of treatment."
The study highlighted that biological changes triggered by excess body fat are a leading risk factor for developing diabetes. Researchers emphasized that obesity is an "important driver" of type 2 diabetes, as is an unhealthy diet. An important driver of the rise in type 2 diabetes rates, and its variation across countries, is obesity and poor diets, which are linked to the disease.
Dr. Ranjit Mohan Anjana from the Madras Diabetes Research Foundation in India said, "Given the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world." He also stated, "Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise through measures such as subsidies for healthy foods and free healthy school meals as well as promoting safe places for walking and exercising including free entrance to public parks and fitness centres."
The study calls for intensified global efforts to tackle the diabetes crisis. It suggests that better diagnosis of diabetes requires innovations such as workplace and community screening programmes, extended or flexible healthcare hours to enable people to visit outside of standard working hours, integration with screening and care for diseases like HIV/AIDS and tuberculosis, and the use of trusted community healthcare providers. Professor Mbanya emphasized, "Better diagnosis of diabetes requires innovations such as workplace and community screening programmes... and the use of trusted community healthcare providers."
Researchers utilized data from over 140 million people aged 18 years or older from more than 1,000 studies in populations of different countries. They included both fasting plasma glucose (FPG) levels and glycated hemoglobin (HbA1c) tests, common diagnostic criteria for diabetes, to ensure accurate estimates. This comprehensive approach was particularly important in regions like South Asia, where relying solely on fasting plasma glucose measurements may have missed numerous undiagnosed cases of diabetes.
In conclusion, the study paints a grim picture of a rising global health issue that remains largely underaddressed, with the global gap in diabetes treatment widening. The findings point to a significant rise in the global diabetes rate, which has doubled since 1990, highlighting urgent treatment gaps that need to be addressed worldwide.
Sources: Disease, The Economic Times, France 24, Al-Rai, emirates247.com, Medical Xpress, ndtv.com, The Straits Times, El Faro de Vigo, Yahoo News, Asharq Al-Awsat, Financial Times, Health, El Peridico, The Hindu, Back to homepage, El Mundo, Izvestia
This article was written in collaboration with generative AI company Alchemiq